How much rates vary
Facilitymedian $2,884 · 10th to 90th $631 to $9,550Professionalmedian $661 · 10th to 90th $89 to $1,096
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $2,290.87 Median $6,606.93 Typical High $12,589.25 | Facility | None | $2,290.87 | $6,606.93 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $5,128.61 | Professional | None | $831.76 | $831.76 | $5,128.61 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $2,187.76 Typical High $7,079.46 | Facility | None | $660.69 | $2,187.76 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $1,258.93 | Professional | None | $660.69 | $812.83 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $131.83 Typical High $660.69 | Professional | 80 · Assistant surgeon | $104.71 | $131.83 | $660.69 |
CareSource Setting Facility Modifier None Typical Low $1,047.13 Median $2,818.38 Typical High $3,630.78 | Facility | None | $1,047.13 | $2,818.38 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $2,818.38 Typical High $4,570.88 | Facility | None | $489.78 | $2,818.38 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,071.52 Typical High $1,621.81 | Professional | None | $831.76 | $1,071.52 | $1,621.81 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $2,884.03 Typical High $4,466.84 | Facility | None | $512.86 | $2,884.03 | $4,466.84 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $851.14 Median $1,071.52 Typical High $1,548.82 | Professional | None | $851.14 | $1,071.52 | $1,548.82 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $524.81 Typical High $912.01 | Professional | None | $70.79 | $524.81 | $912.01 |
SummaCare Setting Facility Modifier None Typical Low $1,548.82 Median $1,621.81 Typical High $1,862.09 | Facility | None | $1,548.82 | $1,621.81 | $1,862.09 |
SummaCare Setting Professional Modifier None Typical Low $707.95 Median $776.25 Typical High $1,023.29 | Professional | None | $707.95 | $776.25 | $1,023.29 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $9,120.11 | Facility | None | $851.14 | $2,630.27 | $9,120.11 |
United Setting Professional Modifier None Typical Low $537.03 Median $891.25 Typical High $1,548.82 | Professional | None | $537.03 | $891.25 | $1,548.82 |
8 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $416.87 Median $416.87 Typical High $1,584.89 | Professional | 52 · Reduced service | $416.87 | $416.87 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $630.96 | Professional | 53 · Discontinued | $165.96 | $165.96 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $2,398.83 | Professional | 54 · Surgery only | $630.96 | $630.96 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $478.63 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $316.23 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $316.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $407.38 Median $512.86 Typical High $794.33 | Professional | 62 · Two surgeons | $407.38 | $512.86 | $794.33 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $114.82 Typical High $177.83 | Professional | AS · PA/NP assist | $91.20 | $114.82 | $177.83 |
Where Ohio sits
The same service costs 3.9 times more in Alaska than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
AK $10,228KY $2,649
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.